SEATTLE – ‘My cup of joy is carved by sorrow,’ are the words that comfort 50-year-old Jessica Neilson.

Neilson says that because she survived a childhood as a Christian Scientist, a religion that encourages prayer instead of medical treatment as the primary method of healing.

She was sexually abused three times – the last time when she was 15. A 21-year-old family friend cut her so badly during the attack she needed a blood transfusion. Her mother was out of town on her honeymoon and her grandmother was in charge of her at the time. Neilson says her grandmother strongly opposed the transfusion, but doctors talked her into giving her permission.

After that sexual assault, which Neilson says happened the day of her mother’s fourth wedding, she developed Post Traumatic Stress Disorder (PTSD). The man who attacked her pleaded guilty to endangering the welfare of a minor and was put on probation after his six-month sentence was suspended, according to court documents. He was also ordered to pay for her hospital and medical expenses.

She never received any therapy, Neilson said – her mother bought her several shirts and the door was closed on that chapter of her life.

For the first 17 years of her life, Neilson had to endure the suffering that came with the chicken pox or the flu – incredible pain that could be relieved from simple medication. Neilson also didn’t receive most of her vaccinations until she joined the Army Reserves at 17.

By the time she entered her 20s, she was diagnosed with Bipolar Disorder Type 1, describing her prognosis at the time as, “If an ax had fallen on me, I was permanently defective.”

“There’s a lot of guilt, especially for having an illness,” she said. “It makes having empathy very hard. When somebody says, ‘Oh, I’m sick,’ normal thought is, ‘Oh, you poor dear.' A Christian Scientist would just mentally practice denying that they’re really sick. It makes for some seriously messed up people.”

A younger brother of one of the girls she attended Sunday School with died in 1979 after suffering severe pain caused by a ruptured appendix. She wrote about the experience in her book ‘God’s Perfect Child,’ with the memoir featured in the Los Angeles Times, CNN and The Atlantic.

“His body lay in his mother's home for two and a half days after his death, as she and a Christian Science practitioner tried to raise him from the dead,” Fraser said.

For Lucia Greenhouse, having grown up in the Christian Science faith in Deephaven, Minnesota, anxiety was never far behind.

“We lived under a cloud of fear and anxiety: that one day, something bad might happen, and our parents would elect prayer over medicine, because that’s what Christian Scientists do,” Greenhouse said. “This was our normal.”

“There is not a day goes by that I don’t struggle with regret, although I don’t call it guilt,” she said.

Hundreds more ex-Christian Scientists say they have gone through devastating experiences and continue to share them anonymously online – too scared to reveal their identities.

Under Washington state law, parents are required to get medical care for sick or injured children or they can be charged with neglect, abuse or even murder. Convictions carry a fine of up to $20,000 or up to 10 years in prison.

Since the 1970s, she says as many as 10 children died in Washington state from treatable diseases. The number is even higher in Idaho, with more than 180, according to Idahochildren.org, a website maintained by Children’s Healthcare Is a Legal Duty, Inc., a nonprofit that tracks child neglect cases.

Swan points to her own experience in the church.

Her only baby boy, Matthew, got sick when he was 15-months-old. She relied on a renowned Christian Science practitioner in Detroit, New Jersey to heal him 41 years ago.

“The mystery immobilized me with the Christian Science logic that the disease was purely a projection of my own ‘wrong thinking,’” Swan wrote in her memoir. “Matthew was a spiritual idea, as perfect and as healthy as God was causing him to be. I was supposed to believe that, and I did.”

According to the memoir, the Christian practitioner who prayed over Swan’s son would say, “Matthew, you cannot be sick. God is your life. You live in the kingdom of God.”

Swan and her husband didn’t take Matthew to the hospital even after he screamed, refused to eat, experienced convulsions and delirious behavior, all because they believed Christian Science practitioners could cure their sick boy.

On the 12th day, Swan took him to the emergency room but only after the Christian Science practitioner recommended he be checked for a broken bone in his neck – one of the few medical visits allowed in the Christian Science faith.

Matthew was diagnosed with meningitis, a curable disease that becomes deadly when left untreated. She says her son suffered irreversible brain damage and died at 16 months. She adds that Christian Science practitioners refused to pray for him after finding out Swan let the doctors conduct more than a broken bone exam.

“I remember Matthew putting my finger on a light switch when he was unable to turn it on himself,” Swan said. “I remember him trying to stretch his arms up to us while he lay delirious with fever. ‘That little boy trusted me for everything,’ I said to many Christian Scientists who called. They all rejected our idea of parental obligation.”

The last reported legal case involving faith healing in Washington was in 2009 when Zachery Swezey died from a ruptured appendix, just four months shy of his 18th birthday. Okanogan County prosecutors charged his parents, Gregory and JaLea Swezey, with second-degree murder. They eventually pleaded guilty to charges of criminal mistreatment with no jail time.

The parents argued that they were persecuted for their religious beliefs. They’re not Christian Scientists, but believed they should receive the same treatment under the law.

Unreported cases may push the death toll even higher, advocates say.

“I believe a tremendous number of deaths and injuries from faith-based medical neglect go unreported,” Swan said. “If parents break with their religion and get medical care at the last minute, the case will almost never come to public attention, even if the child dies in the hospital because of the neglect.”

Bill Scott, media and legislative spokesperson for Christian Science in Washington, says there are 38 Christian Science congregations in the state but the church does not report membership.

Scott said the church doesn’t bar members from taking their children to doctors for medical treatment.

“Our church doesn’t dictate to members in these matters. Often one’s response to rely on Christian Science is guided by prior experience,” Scott said.

The church insists its methods are effective and states there have been 80,000 healings.

Washington is one of 34 states and the District of Columbia that exempt Christian Scientists from child abuse and neglect laws.

“This is a problem in the U.S. where lawmakers all too quickly provide exemptions to religious communities and their practices, and they don’t think twice about it,” said Marci Hamilton,CEO and Academic Director of CHILD USA, an organization that fights to prevent child abuse and neglect in America. “And it tends to be the Republicans who tend to wrap themselves in religious liberty and righteousness, and frankly, they just haven’t figured out yet that children have civil rights and they’re not just martyrs of their parents.”

The amended bill was adopted pro forma– a compromised version that is voted on the floor with no opportunity for additional changes.

“I think this is a highly irregular way to amend a bill,” Swan said. “I thought conference committees were supposed to just piece together provisions in the existing House and Senate bills, not add something out of the blue on their own. There was certainly no opportunity for public discussion or awareness of it. And when a reconciled bill comes back from conference committee usually in the hectic final hours of the legislative session, legislators assume that it’s the best compromise between the chambers and vote for it without much scrutiny.”

In 2014 and twice in 2015, Washington state Senator Mark Mullet tried to get the religious exemption removed. The amended bill never made it to the floor.

“At the time, the Senate chamber was controlled by Republicans and I think there were just concerns about religious freedoms and just letting religion do what they want in terms of religious beliefs,” Senator Mullet said. “When it came out of committee, I got members of the committee to support it, but Republicans were not putting enough priority on it.”

Now Washington state lobbyist Seth Dawson is working with other organizations promoting child welfare safety and with Scott to reach consensus language with the Christian Science Church, hoping to reintroduce a new bill in 2019.

Under the proposed new language, faith-based practices do not constitute negligent treatment or maltreatment unless they pose a clear and present danger to the health, welfare, or safety of the child.

“The bill makes room for parents to use their best judgment in decisions on their children’s care,” Scott said. “It allows for the responsible practice of religious healing, for which I’m grateful, but it doesn’t give parents, whether for religious reasons or otherwise, license to act irresponsibly or dogmatically.”

“Clear and present danger” is defined in existing bills of what constitutes child abuse and neglect for those in Washington state -- this proposed amendment does not explicitly state what kind of suffering constitutes getting medical care or the emotional harm associated with any form of suffering. It allows room for interpretation.

Scott said, “Many of us have had experiences over the years involving the healing of pain. There have been many healings of children of chicken pox and other conditions where the symptoms and the pain haven’t run the medically predicted course, and the children have been healed and free sooner than normally expected. Some of us have also had experiences where painful conditions considered medically ’treatable’ haven’t been helped by medical care.”

But Neilson says the bill leaves too many loopholes.

“I think the proposal leaves far too much in the discretion and interpretation of the individual Christian Scientist to the detriment of their child,” said Neilson, who is a former lawyer and now teaches law at Highline Community College. “I think it could lead to more suffering and death to children of Christian Scientists, to put it bluntly.”

To the outside world, Neilson is a vision of success – she had a clerkship with the United States Court of Appeals for the Second Circuit, graduated from Harvard University, practiced law for 10 years in Los Angeles, and has been teaching law for the past 13 years in Washington state – but, emotionally, she struggled deeply.

“Anger and bitterness will chew you up,” Neilson said. “In my experience, I realized I had to get past that or I wouldn’t survive. I set out specifically on a forgiveness journey, I did it through counseling, I did it through books, through studying forgiveness, my newfound relationship with Jesus Christ, and several 12-step programs. I’ve forgiven the multiple sexual abusers.”